What Is Inverse Psoriasis?

Psoriasis typically occurs on the elbows and knees. However, when you have inverse psoriasis, the skin lesions may be discolored patches in the skin folds or creases. In other words, affected areas might include the armpits or groin area.

The skin condition has some risk factors and can have various triggers. Inverse psoriasis treatment might involve a combination of treatments, from topical options to oral medications. Here's what else you need to know about the condition, its symptoms, causes, and more.

Inverse Psoriasis Symptoms

In most cases, inverse psoriasis is a shiny, smooth skin rash that can sometimes feel sore or painful. People may see red or pink areas on lighter skin and violet, gray, or dark brown areas on darker skin. The rashes can also look raw and may have a little silvery-white coating or none.

The lesions form in skin-to-skin areas, such as:

• Armpits
• The crease of the buttocks
• Groin
• Underneath the breasts

In addition, a rash as part of inverse psoriasis may feel moist to the touch, and you may experience skin irritation. You may find that you feel worse in the warmer months or after you’ve been active. This particular rash may become more inflamed due to heat and friction.

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What Causes Inverse Psoriasis?

The exact cause of psoriasis is unknown. However, your environment, genes, and immune system can play a role in the condition's development. For example, the following can worsen or trigger psoriasis:

• Certain medications such as beta-blockers, lithium, NSAIDs, and prednisone
• Dry or cold weather
• Excessive alcohol use
• Infections
• Skin injuries like cuts or burns
• Smoking
• Stress

Risk Factors

One primary risk factor for inverse psoriasis is having deep skin folds. Another one is having overweight or obesity.

How Is Inverse Psoriasis Diagnosed?

A dermatologist can diagnose inverse psoriasis by physically examining the affected areas and asking about symptoms and family history. The dermatologist may also need to do additional testing, including a:

• Dermoscopy: A healthcare provider examines the skin by magnifying it to get a closer look at the skin and its features.
• Skin biopsy: A provider will numb the skin and take a sample for examination.
  

Treatments for Inverse Psoriasis

There are many treatment options for inverse psoriasis. The options may depend on what dermatologists recommend first and the severity of the condition.

First-Line Treatments

The following are treatments that a dermatologist may recommend or prescribe first for someone with inverse psoriasis:

• Non-steroidal topical treatments, such as Vtama and Zoryve
• Topical calcineurin inhibitors (TCIs) like tacrolimus or pimecrolimus—considered less effective than steroids but come with fewer side effects
• Topical corticosteroids—considered the most effective first-line treatment
• Topical vitamin D analogs, which are ointments

Second-Line Treatments

If first-line treatments don't work, you might have to use emollients—moisturizers that help maintain the health and integrity of the skin barrier and help skin feel smoother—or topical tar-based products. Tar-based products aren't used often because they can irritate the skin. However, people can usually tolerate emollients and may use them with steroids.

Treatments for Severe Inverse Psoriasis

There are many treatments that a dermatologist may recommend or prescribe for severe cases of inverse psoriasis, including:

• Biologics, or medications that selectively target specific proteins in the immune system
• Options to apply to the skin, including antimicrobials, antiseptics, and retinoids
• Oral systemic medications that affect the body as a whole like cyclosporine and methotrexate
  

How to Prevent Inverse Psoriasis

It's not possible to prevent psoriasis. However, you can reduce or prevent flare-ups by:

• Adhering to your treatment plan
• Avoiding any psoriasis triggers
• Keeping your skin clean and moisturized
• Not scrubbing too hard during baths and showers
• Taking daily baths or showers

Related Conditions

If you have inverse psoriasis, you might also have another kind of psoriasis elsewhere on your body. You can also develop infections—such as yeast or fungal infections.

A warm, moist environment can occur when skin rubs together. In moist areas of the skin, yeast, fungus, and bacteria can grow, potentially resulting in skin infections.

Living With Inverse Psoriasis

There's no cure for psoriasis, so it's considered a skin condition a person can have for a lifetime. Sometimes, a person may experience the disappearance of psoriasis—only for it to return later. However, you can manage the condition by consulting with a dermatologist to determine a treatment plan that can work for you.

A Quick Review

Inverse psoriasis is a skin condition that causes discolored rashes in areas where the skin folds. People with deep skin folds and a higher weight may be more likely to develop inverse psoriasis. Though this type of psoriasis is uncurable, there are various ways to relieve your symptoms. Speak with a dermatologist about the best treatment plan for you.